Complementary and Alternative Medicine for Managing Pain

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (20 January 2022) | Viewed by 33582

Special Issue Editor

PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
Interests: rehabilitation; mobility; postural control; motor control; pain; complementary and alternative medicine; spinal cord stimulation; sensorimotor integration; neuromuscular plasticity
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Special Issue Information

Dear Colleagues,

According to the International Association for the Study of Pain, it has been estimated that up to 20% adults suffer from pain and that another 10% are diagnosed with chronic pain each year. Pain is considered a major public health issue with societal and financial burdens. It is well established that pain dramatically affects motor control, psychological states and quality of life. To manage chronic pain, the first indication and the most frequently used intervention remains pharmacological. While medication can produce benefits, the literature reports dangerous side effects such as addiction, misuse, drowsiness and/or cognitive dysfunction, functional impairments, etc. To avoid overmedication, complementary and alternative medicine (CAM) techniques, such as hypnosis, Reiki, mindfulness, relaxation therapy, etc., are now strongly considered as means of managing pain. While the use of CAM is growing in interest, evidence-based medicine is still lacking. The purpose of this Special Issue is to share valuable knowledge and the most recent developments in CAM use to manage pain.

The aim of this Special Issue is to welcome researchers to submit scientific and clinical work on relevant clinical aspects of pain management with complementary and alternative medicine. All the articles will be subject to peer review to ensure quality publications.

Dr. Maxime Billot
Guest Editor

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Keywords

  • Hypnosis
  • Mindfulness
  • Reiki
  • Acupuncture
  • Dry needling
  • Massage
  • Aromatherapy
  • Reflexology
  • Ayurveda
  • Yoga
  • Traditional Chinese medicine
  • Art therapy
  • Dance therapy
  • Qi qigong
  • Tai chi

Published Papers (9 papers)

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Research

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9 pages, 1003 KiB  
Article
Efficacy of Listening to Music on Pain Reduction during Colposcopy-Directed Cervical Biopsy: A Randomized, Controlled Trial
by Lalita Pradit, Charuwan Tantipalakorn, Kittipat Charoenkwan, Prapaporn Suprasert, Jatupol Srisomboon and Tanarat Muangmool
Medicina 2022, 58(3), 429; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58030429 - 16 Mar 2022
Cited by 1 | Viewed by 2135
Abstract
Background and Objective: To investigate the efficacy of listening to music on pain reduction during colposcopy-directed cervical biopsy (CDB). Materials and Methods: From June 2020 to November 2021, 240 women undergoing CDB were enrolled. The participants were randomized into three groups: Group [...] Read more.
Background and Objective: To investigate the efficacy of listening to music on pain reduction during colposcopy-directed cervical biopsy (CDB). Materials and Methods: From June 2020 to November 2021, 240 women undergoing CDB were enrolled. The participants were randomized into three groups: Group 1, colposcopic examination while wearing headphones and listening to music; Group 2, colposcopy while wearing headphones but not listening to music; Group 3 (control group), colposcopy while neither listening to music nor wearing headphones. All participating women completed a 10 cm visual analog scale for subjective pain at three time points: baseline, immediately after cervical biopsy, and 15 min after the procedure. The primary endpoint was the biopsy pain score. Result: Of the 240 women, a sample size of 80 was randomly assigned per group. The clinical–pathological and procedure-related characteristics of the participants in all groups were similar. The mean baseline pain score between each group was not significantly different (2.83 in the music group, 2.54 in group 2, and 2.94 in the control group, p = 0.47). There were no significant differences between each group in terms of mean biopsy pain score (4.21 in the music group, 4.24 in group 2, and 4.30 in the control group, p = 0.98). The differences in changes between the baseline pain score and the biopsy pain score were not statistically significant (1.39 in the music group, 1.70 in group 2, and 1.36 in the control group, p = 0.69). In the multiple comparison analysis, the differences in changes between the biopsy pain score and the baseline pain score between each group were also not statistically significant. There were no complications with the intervention observed. Conclusion: This study demonstrated that there was no beneficial effect of listening to music on pain reduction during colposcopy-directed cervical biopsies. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
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Review

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9 pages, 348 KiB  
Review
A Comprehensive Review of Pain Interference on Postural Control: From Experimental to Chronic Pain
by Frédéric J. F. Viseux, Martin Simoneau and Maxime Billot
Medicina 2022, 58(6), 812; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58060812 - 16 Jun 2022
Cited by 11 | Viewed by 2646
Abstract
Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. [...] Read more.
Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized in the lower back or in the leg induced postural control alteration. Although proprioceptive and cortical excitability seem modified with pain, spinal modulation assessment might provide a new understanding of the pain phenomenon related to postural control. The literature highlights that the motor control of trunk muscles in patient presenting with lower back pain could be dichotomized in two populations, where the first over-activates the trunk muscles, and the second under-activates the trunk muscles; both generate an increase in tissue loading. Taking all these findings into account will help clinician to provide adapted treatment for managing both pain and postural control. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)

Other

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12 pages, 1093 KiB  
Perspective
Acceptance and Commitment Therapy to Increase Resilience in Chronic Pain Patients: A Clinical Guideline
by Maarten Moens, Julie Jansen, Ann De Smedt, Manuel Roulaud, Maxime Billot, Jorne Laton, Philippe Rigoard and Lisa Goudman
Medicina 2022, 58(4), 499; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58040499 - 30 Mar 2022
Cited by 7 | Viewed by 2985
Abstract
Chronic pain remains a very difficult condition to manage for healthcare workers and patients. Different options are being considered and a biopsychosocial approach seems to have the most benefit, since chronic pain influences biological, psychological and social factors. A conservative approach with medication [...] Read more.
Chronic pain remains a very difficult condition to manage for healthcare workers and patients. Different options are being considered and a biopsychosocial approach seems to have the most benefit, since chronic pain influences biological, psychological and social factors. A conservative approach with medication is the most common type of treatment in chronic pain patients; however, a lot of side effects are often induced. Therefore, a premium is set on novel nonpharmacological therapy options for chronic pain, such as psychological interventions. Previous research has demonstrated that resilience is a very important aspect in coping with chronic pain. A more recent type of cognitive-behavioural therapy is Acceptance and Commitment Therapy, in which psychological flexibility is intended to be the end result. In this manuscript, current evidence is used to explain why and how a comprehensive and multimodal treatment for patients with chronic pain can be applied in clinical practice. This multimodal treatment consists of a combination of pain neuroscience education and cognitive-behavioural therapy, more specifically Acceptance and Commitment Therapy. The aim is to provide a clinical guideline on how to contribute to greater flexibility and resilience in patients with chronic pain. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
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5 pages, 274 KiB  
Brief Report
The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain
by Chantal Wood, Gaëlle Martiné, Gaëlle Espagne-Dubreuilh, Karine Le Goff, Maarten Moens, Lisa Goudman, Sandrine Baron, Romain David, Nicolas Naïditch, Maxime Billot and Philippe Rigoard
Medicina 2022, 58(2), 220; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58020220 - 01 Feb 2022
Cited by 4 | Viewed by 1969
Abstract
To improve pain relief for refractory pain condition, spinal cord stimulation (SCS) needs to target the dedicated neuronal fibers within the dorsal columns. Intraoperative feedback from the patient can optimize lead placement but requires “awake surgery”, allowing interaction between patient and surgeon. This [...] Read more.
To improve pain relief for refractory pain condition, spinal cord stimulation (SCS) needs to target the dedicated neuronal fibers within the dorsal columns. Intraoperative feedback from the patient can optimize lead placement but requires “awake surgery”, allowing interaction between patient and surgeon. This can produce negative effects like anxiety and stress. To better manage these aspects, we propose to combine intraoperative hypnosis with awake anesthesia. Seventy-four patients (35 females, 22–80 years) presenting with chronic refractory pain, were offered intraoperative hypnosis during awake SCS lead implantation. Interactive conversational hypnosis was used as well as interactive touch, which was enhanced during painful moments during the lead intraoperative programming. All patients participated actively during the intraoperative testing which helped to optimize the lead positioning. They kept an extremely positive memory of the surgery and of the hypnotic experience, despite some painful moments. Pain could be reduced in these patients by using interactions and touch, which works on Gate Control modulation. Positive memory was reinforced by congratulations to create self-confidence and to induce positive expectations, which could reinforce the Diffuse Noxious Inhibitory Controls at the spinal level. Cooperation was improved because the patient was actively participating and thus, much more alert when feedback was required. Combining intraoperative hypnosis with awake anesthesia appears helpful for SCS lead implantation. It enhances patient cooperation, allows optimization of lead positioning, and leads to better pain control, positive and resourceful memory. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
28 pages, 2078 KiB  
Systematic Review
Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and Meta-Analysis
by Ji-yong Bae, Hyun-Kyung Sung, Na-Yoen Kwon, Ho-Yeon Go, Tae-jeong Kim, Seon-Mi Shin and Sangkwan Lee
Medicina 2022, 58(1), 44; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58010044 - 28 Dec 2021
Cited by 25 | Viewed by 6364
Abstract
Background and Objectives: Migraine headaches are chronic neurological diseases that reduce the quality of life by causing severe headaches and autonomic nervous system dysfunction, such as facial flushing, nasal stuffiness, and sweating. Their major treatment methods include medication and cognitive behavioral therapy [...] Read more.
Background and Objectives: Migraine headaches are chronic neurological diseases that reduce the quality of life by causing severe headaches and autonomic nervous system dysfunction, such as facial flushing, nasal stuffiness, and sweating. Their major treatment methods include medication and cognitive behavioral therapy (CBT). CBT has been used for pain treatment and various psychogenic neurological diseases by reducing pain, disability, and emotional disorders caused by symptoms of mental illness and improving the understanding of mental health. This study aimed to evaluate the effectiveness and safety of CBT in treating migraines. Materials and Methods: Seven electronic databases were searched from the date of inception to December 2020. Randomized controlled studies (RCTs) using CBT as an intervention for migraine were included. The primary outcome of this study was to determine the frequency of migraines and the intensity of migraines on Visual Analog Scale (VAS), the frequency of drug use, Migraine Disability Assessment (MIDAS), and Headache Impact Test (HIT-6) index. The two authors independently conducted the data extraction and quality assessment of the included RCTs, and conducted meta-analysis with RevMan V.5.4. Results: Among the 373 studies, 11 RCTs were included in this systematic review. Seven out of the 11 RCTs were conducted in the USA, and four were conducted in the UK, Germany, Iran, and Italy, respectively. Headache frequency and MIDAS scores were statistically significant reduced. In the subgroup analysis, headache strength was significantly reduced. Two of the included studies reported adverse effects, including worsening of migraine intensity and frequency, respiratory symptoms, and vivid memory of a traumatic event. Conclusions: CBT for migraine effectively reduced headache frequency and MIDAS score in meta-analysis and headache intensity subgroup analysis, with few adverse events. Additional RCTs with CBT for migraine headaches are needed for a more accurate analysis. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
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19 pages, 1712 KiB  
Study Protocol
Comparison of Spinal Cord Stimulation vs. Dorsal Root Ganglion Stimulation vs. Association of Both in Patients with Refractory Chronic Back and/or Lower Limb Neuropathic Pain: An International, Prospective, Randomized, Double-Blinded, Crossover Trial (BOOST-DRG Study)
by Philippe Rigoard, Manuel Roulaud, Lisa Goudman, Nihel Adjali, Amine Ounajim, Jimmy Voirin, Christophe Perruchoud, Bénédicte Bouche, Philippe Page, Rémy Guillevin, Mathieu Naudin, Martin Simoneau, Bertille Lorgeoux, Sandrine Baron, Kevin Nivole, Mathilde Many, Iona Maitre, Raphaël Rigoard, Romain David, Maarten Moens and Maxime Billotadd Show full author list remove Hide full author list
Medicina 2022, 58(1), 7; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58010007 - 21 Dec 2021
Cited by 6 | Viewed by 4364
Abstract
While spinal cord stimulation (SCS) is a well-established therapy to address refractory persistent spinal pain syndrome after spinal surgery (PSPS-T2), its lack of spatial selectivity and reported discomfort due to positional effects can be considered as significant limitations. As alternatives, new waveforms, such [...] Read more.
While spinal cord stimulation (SCS) is a well-established therapy to address refractory persistent spinal pain syndrome after spinal surgery (PSPS-T2), its lack of spatial selectivity and reported discomfort due to positional effects can be considered as significant limitations. As alternatives, new waveforms, such as burst stimulation and different spatial neural targets, such as dorsal root ganglion stimulation (DRGS), have shown promising results. Comparisons between DRGS and standard SCS, or their combination, have never been studied on the same patients. “BOOST DRG” is the first prospective, randomized, double-blinded, crossover study to compare SCS vs. DRGS vs. SCS+DRGS. Sixty-six PSPS-T2 patients will be recruited internationally in three centers. Before crossing over, patients will receive each stimulation modality for 1 month, using tonic conventional stimulation. After 3 months, stimulation will consist in switching to burst for 1 month, and patients will choose which modality/waveform they receive and will then be reassessed at 6 and 12 months. In addition to our primary outcome based on pain rating, this study is designed to assess quality of life, functional disability, psychological distress, pain surface coverage, global impression of change, medication quantification, adverse events, brain functional imaging and electroencephalography, with the objective being to provide a multidimensional insight based on composite pain assessment. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
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8 pages, 1521 KiB  
Case Report
Cannabis Dopaminergic Effects Induce Hallucinations in a Patient with Parkinson’s Disease
by Katie Pizzolato, David Thacker, Nicole Del Toro-Pagán, Abeer Hanna, Jacques Turgeon, Adriana Matos, Nishita Amin and Veronique Michaud
Medicina 2021, 57(10), 1107; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57101107 - 14 Oct 2021
Cited by 3 | Viewed by 3648
Abstract
Cannabis products that contain the tetrahydrocannabinol (THC) cannabinoid are emerging as promising therapeutic agents for the treatment of medical conditions such as chronic pain. THC elicits psychoactive effects through modulation of dopaminergic neurons, thereby altering levels of dopamine in the brain. This case [...] Read more.
Cannabis products that contain the tetrahydrocannabinol (THC) cannabinoid are emerging as promising therapeutic agents for the treatment of medical conditions such as chronic pain. THC elicits psychoactive effects through modulation of dopaminergic neurons, thereby altering levels of dopamine in the brain. This case report highlights the complexity associated with medicinal cannabis and the health risks associated with its use. A 57-year-old male with Parkinson’s disease was experiencing worsening tremors and vivid hallucinations despite therapy optimization attempts. It was discovered that the patient took cannabis for chronic back pain, and a pharmacogenomics (PGx) test indicated the presence of variants for the COMT and HTR2A genes. These variants could increase dopamine levels and predispose patients to visual hallucinations. Once the cannabis was discontinued, the patient’s hallucinations began to slowly dissipate. Cannabis use continues to expand as it gains more acceptance legally and medicinally, but cannabis can affect the response to drugs. This patient case suggests that cannabis use in combination with dopamine-promoting drugs, especially in a patient with genetic variants, can increase the risk for vivid hallucinations. These conditions support the importance of considering herb–drug interactions and PGx data when performing a medication safety review. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
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5 pages, 264 KiB  
Opinion
Self-Reiki, Consideration of a Potential Option for Managing Chronic Pain during Pandemic COVID-19 Period
by Maxime Billot, Maeva Daycard and Philippe Rigoard
Medicina 2021, 57(9), 867; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57090867 - 25 Aug 2021
Cited by 4 | Viewed by 5543
Abstract
While the world faces an unprecedented situation with the pandemic, other chronic diseases such as chronic pain continue to run their course. The social distancing and restrictive displacement imposed by the pandemic situation represents a new barrier to access to pain management and [...] Read more.
While the world faces an unprecedented situation with the pandemic, other chronic diseases such as chronic pain continue to run their course. The social distancing and restrictive displacement imposed by the pandemic situation represents a new barrier to access to pain management and tends to reinforce chronification process. Given this context, complementary and alternative medicine (CAM) might offer new opportunities to manage CP, notably with a hand-touch method, such as self-Reiki therapy. Although Reiki administered by a practitioner has shown promising results to reduce pain and psychological distress, and to improve quality of life, self-Reiki practice needs evidence-based medicine to be disseminated. Overall, self-Reiki could bring positive results in addition to, and without interfering with, conventional medicine approaches in patients experienced chronic pain. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
9 pages, 1059 KiB  
Case Report
Cognitive–Evaluative Dimension of Pain in Neuropathic Pain Relapse in Sciatica: A Case Report
by Tsubasa Kawasaki, Takuya Yada and Masahiro Ohira
Medicina 2021, 57(7), 658; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57070658 - 27 Jun 2021
Viewed by 2324
Abstract
The cognitive–evaluative (C–E) dimension of pain is commonly observed in patients with a relatively long duration of pain. However, little is known about the effects of pain relapse on the C–E dimension of pain. Moreover, the improvement process of the C–E dimension of [...] Read more.
The cognitive–evaluative (C–E) dimension of pain is commonly observed in patients with a relatively long duration of pain. However, little is known about the effects of pain relapse on the C–E dimension of pain. Moreover, the improvement process of the C–E dimension of pain following treatment is unknown. The objective of this case report was to (a) demonstrate that the C–E dimension was affected in the acute phase of neuropathic pain in cases of pain relapse, and (b) demonstrate the improvement process of the C–E dimension of pain. A woman was diagnosed with low back pain (LBP) and sciatica. The patient had previously experienced symptoms of LBP and sciatica; thus, this episode was a case of pain relapse. At the beginning of rehabilitation, the C–E dimension of pain was present in addition to the sensory–discriminative (S–D) dimension of pain. It was observed that improvement of the C–E dimension of pain was delayed in comparison with that of the S–D dimension of pain. The C–E dimension of pain was observed with pain relapse even though it was in the acute phase of pain. This case provides a novel insight into the C–E dimension of pain. Moreover, the delay in improving the C–E dimension of pain indicates a difference in the improvement process for each pain dimension. Full article
(This article belongs to the Special Issue Complementary and Alternative Medicine for Managing Pain)
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